In this study, the laser parameters for the efficient thermal modification of dentin with minimum heat deposition at CO(2) laser wavelengths were firmly established.
New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence and for resolving the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the resolution of interproximal and occlusal caries, early root caries, and secondary caries around composite fillings. Longitudinal measurements of lesion progression established a strong correlation (p<0.001) between the reflected light from the lesion area and the square root of time indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.
The characteristics of laser-treated tooth surfaces depend on the laser wavelength, pulse duration, spatial and temporal laser beam quality, incident fluence, surface roughness, and the presence of water during irradiation. Ablated surfaces are most commonly restored with adhesive dental materials and the characteristics of the ablated surfaces influence adhesion of restorative materials. Previous studies suggest that high bond strengths can be achieved using shorter laser pulses that minimize peripheral thermal damage. In this study, Er:YSGG, Er:YAG, and CO(2) lasers were used at irradiation intensities sufficient to simulate efficient clinical caries removal to uniformly irradiate bovine enamel and human dentin surfaces using a motion control system with a microprocessor-controlled water spray. The degree of spatial overlap of adjacent pulses was varied so as to investigate the influence of irradiation uniformity and surface roughness on the bond strength. Composite resin was bonded to the irradiated surfaces and shear bond tests were used to obtain bond strengths in MPa. The highest results were obtained using the Er:YAG pulses with pulse durations less than 35 mus without the necessity for postirradiation acid etching. Some of these groups were not significantly different from nonirradiated, acid-etch-only positive control groups.
High resolution SR-FTIR is well suited for characterization of the chemical changes that occur due to thermal damage peripheral to laser incisions in proteinaceous hard tissues. Sub-microsecond pulsed IR lasers resonant with water and mineral absorption bands ablate dentin efficiently with minimal thermal damage. Similar laser parameters are expected to apply to the ablation of alveolar bone.
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